Stan Smits

Stan SmitsPhilips Healthcare14 May 2008

A vendor’s view on eHealth

214 May 2008 - Stan Smits Philips Healthcare

Source: Medistat

Source: OECD, WHO, PH Internal Analysis

30%

2%

8%

1% 5%

54%

Americas

Europe, Mid-East,Africa

China/HK

J apan

India

Rest of Asia

US Healthcare Expenditure:~ US$ 2,000 bln in 2007 ~ US$ 4,300 bln in 2017

Worldwide Healthcare Expenditure: ~ US$ 4,000 bln in 2006

US healthcare jobs vs manufacturing1977 8% 22%2007 11% 10%Source Wall Street Journal

Healthcare is the world’s largest service sector

Healthcare cost will grow from 9% of worldwide GDP in 2005 to ~11% in 2015in US from 16% of GDP in 2007 to ~20% GDP in 2017

0%

2%

4%

6%

8%

10%

1950 2005 20151990


Key challenges for the healthcare systems

Building sustainable healthcare systems:

• Value-based reimbursement systems

• Reducing the prevalence of chronic disease

• Coping with the shortage in healthcare personnel

• Reducing healthcare variability

Europe’s population by age groups, 1950-2050

Source: OECD Health Care Quality Indicators ProjectHealth Working Paper 22, 2006

Country differences in hospital mortality rates

13.8

5.3

35

6.9

18

27

0

5

10

15

20

25

30

35

40

Heart infarct Colon Cancer Stroke


Value-based healthcare delivery

From focus on Cost to focus on Value

• Value for patients: – Outcome: mortality, morbidity, physical and mental stress,

length-of stay

– Avoiding medical errors

– Disease specific Care Cycles

• Value for society:– Increasing the health of the population and thus economic value

• Value for healthcare systems:– Continuous improvements for more effectiveness and efficiency

– More competitive healthcare delivery

eHealth is pivotal in this transformation to value-based healthcare delivery


eHealth definition*

1. Clinical Information Systemsa) Specialized tools for professionals within care institutions

b) Tools for primary care and/or outside the care institutions

2. Telemedicine and Homecarea) Personalized health systems and services, disease management

(usually connecting patient to nurse)

b) Tele-medicine, tele-radiology, tele-care, tele-consultation (usually connecting physician to physician)

3. Integrated regional / national health information networks

4. Secondary usage non-clinical systems

* Definition agreed with the ehealth Industry Stakeholders Group reporting to the i2010 subgroup on eHealth


• “eHealth is worth it”: Case study of 10 projects with policy recommendations• “Accelerating the development of the eHealth market in Europe”: lead market

initiative

• FP7 ICT challenge 5: towards sustainable and personalized healthcare• Artemis SP2: Person-centric health management• ITEA2 Roadmap 3 attention for health in the Me, Group and Society domains

eHealth high on the i2010 agenda


2. Process

Prevention Diagnosis Treatment SurveillanceScreening Management

Information and Communication

eHealth key enabler in driving new care delivery models…

… which together deliver a full set of care to a patient with a medical condition


…by integrating patient information…


Discovery to Balloon: Treatment of Heart Attack

Advanced life support monitor

Reliable 12-lead transmission

12-lead forwarding & viewing

Expedite Emergency Department care

Cath Lab or Thrombolytic therapy

Discover Diagnose

Monitor

MRx Monitor/Defibrillator

Transmit

Bluetooth over the Internet

View

12-lead Transfer Station

Transport

IntelliVue Monitor

Treat

Allura 3D-CA Cath Lab

Treat

ECG

Activate Cath Lab

Simultaneous Pagers to all Cath Lab staff

12-ld ECG to Cardiologist’s

Hand-held device

Improve Workflow: Measure component times & feedback

…into Care Cycles (1)



ElectroPhysiology: Integration of information

1114 May 2008 - Stan Smits Philips Healthcare 11


Dutch Mammography Screening:

• 1 Million exams per year

• Exporting and importing > 450 GB per day

• 99.99 % uptime garantee for each component

• More than 835 employees

• Unique screening worklow

• 52 Mobile units


prevention

self care

self pay

chronic care

home care

insurance

eHealth for connecting lifestyle and healthcare

Examples:FP6 MyHeart: Fighting cardiovascular diseases by prevention and early diagnosisFP7 HeartCycle: Closed-loop management of medication and lifestyle compliance


FP7 Project

• Start: March1, 2008

• Duration: 4 years

• Partners: 19 (9 countries)

• Announced EC-funding: ~14.1 M€

– Largest FP7 project in “ICT for Health”

• Coordinator: Philips

Patient Compliance is a major problem in healthcare today.

• Aim: Closed-loop management of medication and lifestyle compliance

• Applications: Heart Failure & Coronary Heart Disease

• Solution:

– Multi-parametric monitoring of vital signs and other variables

– Physiological and statistical modelling of medication and lifestyle effects

– Motivating patients to adhere to treatment regime

– Decision support system for physicians and patients


eHealth as a key enabler for Home Healthcare

• Both in the “prevention” stage and “surveillance” stage of the care cycle, Home Health needs to be integrated into the overall care-cycle view

• Effective chronic disease management and post-discharge monitoring improves patients’ quality of life and reduces recurring hospitalization

Telemonitoring proven to reduce cardiac re-hospitalizations for CHF patients1

eHealth enhances patients’ compliance and self-care regimen

1 TEN-HMS Study published in JACC, May 17, 2005; John GF Cleland, MD, Aggie Balk, MD, et al clinical investigators


Many grassroots eHealth activities

• Microsoft HealthVault

• GoogleHealth

• Many Web 2.0 mash-up services

$144.71 versus $301.23!!


How to encourage adoption of eHealth

• Create a lead market for eHealth at European, national and regional level to connect healthcare providers across the care-cycle, including family doctor, pharmacy, hospital and home care provider

• Address increase in evidence requirements, also in Europe and the slow adoption of proven innovations in the medical community – 15 years from proof of concept to mainstream

• Foster international standards and profiles for eHealth interoperability (DICOM, HL7, IHE, Continua)


In summary, eHealth can catalyze the transformation to value-based healthcare delivery

• Shift from expensive treatment of acute disease in hospital setting to more cost-effective prevention in the primary care setting (however also requires reimbursement incentives)

• Reduce prevalence of chronic disease through early detection and lifestyle compliance

• Reduce the healthcare burden of treating the chronically ill

• Support independent living of the elderly

• Increase productivity to reduce demand for scarce talent and cost

• Increase quality of care using Clinical Decision Support tools

• Improve quality of care and reduce costs through minimally invasive procedures

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